﻿CREATE TABLE [dbo].[CLM_837I_2300_Claim]
(
[Subscriber_NM109_SubscriberPrimaryID] [nvarchar] (80) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Patient_NM109_PatientPrimaryID] [nvarchar] (80) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Claim_CLM01_PatientAccountNumber] [nvarchar] (38) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Claim_CLM02_TotalClaimChargeAmount] [money] NULL,
[Claim_CLM05_FacilityCodeValue] [nvarchar] (38) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Claim_CLM05_FacilityCodeQualifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Claim_CLM05_ClaimFrequencyTypeCode] [nvarchar] (10) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Claim_CLM06_ProviderOrSupplierSignatureIndicator] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Claim_CLM07_MedicareAssignmentCode] [nvarchar] (1) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Claim_CLM08_BenefitsAssignmentCertificationIndicator] [nvarchar] (1) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Claim_CLM09_ReleaseOfInformationCode] [nvarchar] (1) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Claim_CLM18_ExplanationOfBenefitsIndicator] [nvarchar] (1) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Claim_CLM20_DelayReasonCode] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Discharge_DTP01_DischargeDateTimeQualifier] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Discharge_DTP02_DischargeDateTimePeriodFormatQualifier] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Discharge_DTP03_DischargeHour] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Statement_DTP01_StatementDateTimeQualifier] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Statement_DTP02_StatementDateTimePeriodFormatQualifier] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Statement_DTP03_StatementFromOrToDate] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Admission_DTP01_AdmissionDateTimeQualifier] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Admission_DTP02_AdmissionDateTimePeriodFormatQualifier] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Admission_DTP03_AdmissionDateAndHour] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[InsClaim__CL101_AdmissionCode] [nvarchar] (1) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[InsClaim__CL102_AdmissionSourceCode] [nvarchar] (1) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[InsClaim_CL103_PatientStatusCode] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Contract_CN101_ContractTypeCode] [nvarchar] (50) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Contract_CN102_ContractAmount] [nvarchar] (50) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Contract_CN103_ContractPercentage] [nvarchar] (50) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Contract_CN104_ContractCode] [nvarchar] (50) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Contract_CN105_ContractTermDiscountPercentage] [nvarchar] (50) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Contract_CN106_ContractVersionIdentfier] [nvarchar] (50) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Payer_AMT01_PayerAmountQualifierCode] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Payer_AMT02_PayerEstimatedMonetaryAmount] [money] NULL,
[Patient_AMT01_PatientAmountQualifierCode] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Patient_AMT02_PatientEstimatedMonetaryAmount] [money] NULL,
[Patient_AMT01_PatientPaidAmountQualifierCode] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Patient_AMT02_PatientPaidMonetaryAmount] [money] NULL,
[CCard_AMT01_CreditCardAmountQualifierCode] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[CCard_AMT02_CreditOrDebitCardMaximumAmount] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Reprice_REF02_AdjustedRepricedClaimReferenceNumber] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Reprice_REF02_RepricedClaimReferenceNumber] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ClaimID_REF02_ValueAddedNetworkTraceNumber] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[DocID1_REF02_DocumentControlID] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[DocID2_REF02_DocumentControlID] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[OrigRef_REF02_ClaimOriginalReferenceNumber] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[InvesDev_REF02_InvestigationalDeviceExemptionID] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[SvcAuth_REF02_ServiceAuthorizationExceptionCode] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[PeerReview_REF02_PeerReviewAuthorizationNumber] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[PriorAuth_REF02_1PriorAuthOrReferralNumber] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ReferralNum_REF02_1PriorAuthOrReferralNumber] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[PriorAuth_REF02_2PriorAuthOrReferralNumber] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ReferralNum_REF02_2PriorAuthOrReferralNumber] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[MedRecord_REF02_MedicalRecordNumber] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[DemoProject_REF02_DemonstrationProjectID] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[BillingNote_NTE01_BillingNoteReferenceCode] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[BillingNote_NTE02_BillingNoteText] [nvarchar] (80) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR601_PrognosisCode] [nvarchar] (1) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR602_ServiceFromDate] [nvarchar] (8) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR603_DateTimeFormatQualifier] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR604_HomeHealthCertificationPeriod] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR605_DiagnosisDate] [nvarchar] (8) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR606_SkilledNursingFacilityInd] [nvarchar] (1) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR607_MedicareCoverageInd] [nvarchar] (1) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR608_CertificateTypeCode] [nvarchar] (1) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR609_SurgeryDate] [nvarchar] (8) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR610_ProductServiceIdQualifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR611_SurgicalProcedureCode] [nvarchar] (15) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR612_PhysicianOrderDate] [nvarchar] (8) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR613_LastVisitDate] [nvarchar] (8) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR614_PhysicianContactDate] [nvarchar] (8) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR615_DateTimeFormatQualifier] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR616_LastAdmissionPeriod] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR7617_PatientLocationCode] [nvarchar] (1) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR618_SecondaryDiagnosisDate1] [nvarchar] (8) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR619_SecondaryDiagnosisDate2] [nvarchar] (8) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR620_SecondaryDiagnosisDate3] [nvarchar] (8) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[HHCCertification_CR621_SecondaryDiagnosisDate4] [nvarchar] (8) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[PrinAdmCode_HI01_PrincipalAdmittingECode1] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[PrinAdmCode_HI02_CodeListQualifierECode2] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[PrinAdmCode_HI02_PrincipalAdmittingECode2] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[PrinAdmCode_HI03_PrincipalAdmittingECode3] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[DRG_HI01_DRGCode] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[PrinProcCode_HI01_1CodeListQualifierCode] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[PrinProcCode_HI01_2PrincipalProcedureCode] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[PrinProcCode_HI01_4DateTimePeriod] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ClaimPricing_HCP01_PricingMethodology] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ClaimPricing_HCP02_RepricedAllowedAmount] [money] NULL,
[ClaimPricing_HCP03_RepricedSavingAmount] [money] NULL,
[ClaimPricing_HCP04_RepricingOrganizationID] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ClaimPricing_HCP05_RepricingPerDiemOrFlatRateAmount] [money] NULL,
[ClaimPricing_HCP06_RepricedApprovedDRGCode] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ClaimPricing_HCP07_RepricedApprovedAmount] [money] NULL,
[ClaimPricing_HCP08_RepricedApprovedRevenueCode] [nvarchar] (48) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ClaimPricing_HCP09_RepricedProductOrServiceIDQualifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ClaimPricing_HCP10_RepricedApprovedHCPCSCode] [nvarchar] (48) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ClaimPricing_HCP11_RepricedUnitOrBasisForMeasurementCode] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ClaimPricing_HCP12_RepricedApprovedServiceUnitCount] [int] NULL,
[ClaimPricing_HCP13_RepricedRejectReasonCode] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ClaimPricing_HCP14_RepricedPolicyComplianceCode] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[ClaimPricing_HCP15_RepricedExceptionCode] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM102_AttendingPhysicianTypeQualifier] [nvarchar] (1) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM103_AttendingPhysicianLastName] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM104_AttendingPhysicianFirstName] [nvarchar] (25) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM105_AttendingPhysicianMiddleName] [nvarchar] (25) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM107_AttendingPhysicianNameSuffix] [nvarchar] (25) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM108_AttendingPhysicianIdCodeQualifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM109_AttendingPhysicianPrimaryID] [nvarchar] (80) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_PRV01_AttendingProviderCode] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_PRV03_AttendingProviderTaxonomyCode] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM103_OperatingPhysicianLastName] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM104_OperatingPhysicianFirstName] [nvarchar] (25) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM105_OperatingPhysicianMiddleName] [nvarchar] (25) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM107_OperatingPhysicianNameSuffix] [nvarchar] (25) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM108_OperatingPhysicianIdCodeQualifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM109_OperatingPhysicianPrimaryID] [nvarchar] (80) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM103_OtherPhysicianLastName] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM104_OtherPhysicianFirstName] [nvarchar] (25) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM105_OtherPhysicianMiddleName] [nvarchar] (25) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM107_OtherPhysicianNameSuffix] [nvarchar] (25) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM108_OtherPhysicianIdCodeQualifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Physician_NM109_OtherPhysicianPrimaryID] [nvarchar] (80) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Facility_NM101_ServiceFacilityEntityIDCode] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Facility_NM102_ServiceFacilityEntityTypeQualifier] [nvarchar] (1) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Facility_NM103_ServiceFacilityLaboratoryOrFacilityName] [nvarchar] (35) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Facility_NM108_ServiceFacilityIdentificationCodeQualifier] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Facility_NM109_LaboratoryOrFacilityPrimaryID] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Facility_N301_LaboratoryOrFacilityAddressLine1] [nvarchar] (55) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Facility_N302_LaboratoryOrFacilityAddressLine2] [nvarchar] (55) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Facility_N401_LaboratoryOrFacilityCityName] [nvarchar] (30) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Facility_N402_LaboratoryOrFacilityStateOrProvinceCode] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Facility_N403_LaboratoryOrFacilityPostalZoneOrZIPCode] [nvarchar] (15) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Facility_N404_CountryCode] [nvarchar] (3) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[LastClaimStatusCode] [nvarchar] (2) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[IsPatient] [nvarchar] (10) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Subscriber_HL01_SubscriberHierarchicalIDNumber] [nvarchar] (12) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[Patient_HL01_PatientHierarchicalIDNumber] [nvarchar] (12) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[IDKey] [int] NOT NULL IDENTITY(1, 1),
[ST01_EDIMessageType] [nvarchar] (50) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[BTSMessageID] [nvarchar] (100) COLLATE SQL_Latin1_General_CP1_CI_AS NULL,
[BTSInterchangeID] [nvarchar] (100) COLLATE SQL_Latin1_General_CP1_CI_AS NULL
) ON [PRIMARY]


